Percutaneous coblation nucleoplasty in patients with contained lumbar disc prolapse: 1 year follow-up in a prospective case series

Abstract

Background: Nucleoplasty appears a successful minimally-invasive treatment for symptomatic contained disc herniation (protrusion). The purpose of this prospective study was to assess the effectiveness of nucleoplasty for alleviating pain and dysfunction in our patients. Method: All patients who presented with established low back and/or leg pain of at least 3 months' duration were clinically followed for 1 year following the nucleoplasty procedure. Self-reported grading of pain using the Visual Analogue Scale (VAS) and the Roland Morris Disability Questionnaire (RMDQ), and subjective global rating of overall satisfaction were recorded and analysed. Results: Eighty-three patients, aged between 20 and 65 years who were treated with nucleoplasty were included in the study. No complications were noted. At the 12-month-follow-up, the median VAS and RMDQ scores were significantly reduced in the patients who were considered successful (VAS by 6-7 points, RMDQ by 8 points) compared to the patients who were considered failed showing much less reduction. (P = 0.000 in both cases; Mann-Whitney U test.) There was no significant difference in the baseline VAS and RMDQ scores in the two groups. Patients who were considered to have failed the procedure tended to be older. Multi-level disc decompression did not appear to be a risk factor for failure. Conclusions: This disc decompression procedure was a safe and effective treatment option for carefully selected patients affected by low back and leg pain due to contained disc herniation. © 2011 Springer-Verlag/Wien.